Vasectomy? be Afraid, be Very Afraid

Vasectomy? Google “Post Vasectomy Pain Syndrome” First…

Vasectomy has been described as a permanent, safe, and effective surgical birth control method for men. Approximately 500,000 vasectomies are performed per year in the United States. This may now encompass around one out of six men over age thirty-five. Vasectomy is now advertised on the Internet on hundreds of sites, many of which describe the procedure in detail. These sites also list the most common complications in the acute post-operative phase and some longer-term complications are occasionally mentioned. For example this site: this site gives a fairly complete description and lists a few side effects. If one read this site and stopped there, you would never know of the true incidence of post-vasectomy problems.

Many of the informational sites are not up to date and gloss over the fairly common post-vasectomy complications that men should know about before they make the decision to pursue a vasectomy. It is true that most men do well after the surgery. In fact, this post-vasectomy surgery lists a 71.4% satisfaction rate, but also lists 19.3% of men with equivocal feelings and 9.3% who were dissatisfied. It also lists an incidence of post-vasectomy testicular pain of 18.7%, which affected quality of life in 2.2%. It is a small survey, with a low response rate, but the numbers who are dissatisfied or unsure are concerning. Also of concern is the incidence of testicular or scrotal pain listed in this study, which was reported by almost one out of five survey responders.

As the numbers of vasectomized men have increased, the numbers of men affected by post-vasectomy complications have also risen and become a focus for clinical studies. In fact, I Googled “Post Vasectomy Pain” while writing this article and got 1,170,000 hits. The incidence of post-vasectomy testicular pain had been variously reported in the literature. In one study, (Br J Urol. 1992 Feb;69(2):188-91.) the incidence of chronic testicular pain was reported to be 33%, with about half of these men reporting it to be “troublesome”, and about 5% of patients had testicular pain related to intercourse. That would seem to put a damper on ones sexual function and interest. Three of the 179 survey respondents regretted having the vasectomy due to chronic pain. The incidence of regret (1 in 60) for an essentially irreversible procedure seems high and merits mention in the informed consent for this procedure. In fact, this study’s conclusion was, “Prior to vasectomy, all patients should be counseled with regard to the risk of chronic testicular pain.” I would go further and say that the informed consent for vasectomy should include a paragraph like this: